Diagnosis of upper gastro-intestinal bleeding.

Mailer, C M; Goldberg, Avishay; Harden, R. McG.; Grey-Thomas, I.; Burnett, W.

doi:10.1136/bmj.2.5465.784

Cited by 26 publications

(9 citation statements)

References 21 publications

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“…Though it is reasonable to expect that improved diagnosis may lead to better management and prognosis, proof of benefit to individual patients is difficult to obtain. The overall hospital mortality in this series was 3-8% which compares favourably with published figures from Britain of 8% (Walls et al, 1971), 8-9% (Schiller et al, 1970, and 9% (Mailer et al, 1965), and from U.S.A. of 8% (Palmer, 1969), 8% (Hedberg, 1966), and 29% (Crook et al, 1972). Early in the period covered by this series some patients admitted with bleeding were not referred for endoscopy.…”

Section: Discussionsupporting

confidence: 80%

“…Radiological reviews (Cooley, 1961) suggest that barium meals detect about 85 % of ulcers in patients without haemorrhage, and greater accuracy in acutely ill patients would be surprising. Detection rates of 73% (Walls et al, 1971), 84% (Mailer et al, 1965), and 92% (Allan et al, 1972) are reported. X-ray films showed 27 of the 46 ulcers early in this series (table IV), but this is not a true assessment of radiology, since some of these patients were selected for endoscopy because of negative x-ray appearances.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical pointers are often misleading (Chandler et al, 1960;Mailer et al, 1965;Palmer, 1969). Ulcers may be found in the absence of previous symptoms and patients with known ulcers or varices may bleed from other sites.…”

mentioning

confidence: 99%

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Early Endoscopy of Oesophagus, Stomach, and Duodenal Bulb in Patients with Haematemesis and Melaena

Cotton¹,

Rosenberg²,

Waldram³

et al. 1973

BMJ

183

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Early Endoscopy of Oesophagus, Stomach, and Duodenal Bulb in Patients with Haematemesis and Melaena

Cotton¹,

Rosenberg²,

Waldram³

et al. 1973

BMJ

183

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“…Although the overall mortality in many large series of patients admitted with acute upper gastrointestinal bleeding in this country varies between 8 and 9% (Mailer, Goldberg, Harden, Grey-Thomas, and Burnett, 1965;Schiller, Truelove, and Williams, 1970;Walls, Glanville, and Chandler, 1971) a recent large series from Scotland reported an overall mortality of 13 7 % . Comparable mortality from the USA varies between 8 % (Palmer, 1969) and 29 % (Crook, Gray, Nance, and Cohn, 1972).…”

Section: Discussionmentioning

confidence: 93%

A prospective comparative trial between early endoscopy and radiology in acute upper gastrointestinal haemorrhage.

McGinn¹,

Guyer²,

Wilken³

et al. 1975

Gut

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SUMMARY A prospective comparative trial is reported between the results of early endoscopy and barium meal examinations in 150 patients admitted with acute upper gastrointestinal haemorrhage. One hundred and thirty-eight patients underwent both investigations within 24 hours of admission. Emergency endoscopy accurately identified the source of haemorrhage in 86% of patients and emergency radiology identified the source in 51 %. Misleading positive reports were given endoscopically in 3 % and by barium meal in 8 %. The identification of the source of haemorrhage was possible in 126 patients (91 %) by the use of both methods. Emergency endoscopy is shown to be superior to emergency barium meal examination, but the examinations are complementary and both should be used for these patients.

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“…7., 1965) and the operative management discussed. Mailer, Goldberg, Harden, Grey-Thomas, and Burnett (1965) have demonstrated that accurate diagnosis within 24 hours of admission is feasible, but there is no unanimity of opinion about the correct surgical approach. Encouragement to employ conservative procedures is based mainly on the reports of Farris and Smith (1960), Dorton (1961), and Foster, Hunt, and Dunphy (1964).…”

Section: Discussionmentioning

confidence: 99%

Conservative surgery for bleeding peptic ulcer.

Carruthers¹,

Giles²,

Clark³

et al. 1967

BMJ

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1967, 1,[80][81][82] 3leeding peptic ulcer accounts for 80 to 85 ! ; ; of hospital admissions for gastrointestinal haemorrhage (Tanner, 1954 Avery Jones, 1957Aird, 1957). Improved supportive therapy and greater co-operation between physicians and surgeons have lowered the mortality in this condition. Mortality is influenced by the age of the patient, the severity of the bleeding, and the site of the ulcer. Patients over the age of 50 who continue to bleed may die unless treated surgically (Avery Jones, 1947). Chinn, Littell, Badger, and Beams (1956) pyloroplasty after dealing with a duodenal ulcer was so unsatisfactory that a gastroenterostomy was added.The mortality from operations is shown in Table I, and there is an apparent bias in favour of conservative surgery except in the treatment of erosions. One of the criticisms of conservative surgery has been a high incidence of postoperative bleeding. This is examined in Table II

show abstract

Diagnosis of upper gastro-intestinal bleeding.

Cited by 26 publications

References 21 publications

Early Endoscopy of Oesophagus, Stomach, and Duodenal Bulb in Patients with Haematemesis and Melaena

Early Endoscopy of Oesophagus, Stomach, and Duodenal Bulb in Patients with Haematemesis and Melaena

A prospective comparative trial between early endoscopy and radiology in acute upper gastrointestinal haemorrhage.

Conservative surgery for bleeding peptic ulcer.

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